35 research outputs found
Candidiasis, Bacterial Vaginosis, Trichomoniasis and Other Vaginal Conditions Affecting the Vulva
info:eu-repo/semantics/publishedVersio
Identifying metabolite markers for preterm birth in cervicovaginal fluid by magnetic resonance spectroscopy
Introduction Preterm birth (PTB) may be preceded by
changes in the vaginal microflora and metabolite profiles.
Objectives We sought to characterise the metabolite
profile of cervicovaginal fluid (CVF) of pregnant women
by 1H NMR spectroscopy, and assess their predictive value
for PTB.
Methods A pair of high-vaginal swabs was obtained from
pregnant women with no evidence of clinical infection and
grouped as follows: asymptomatic low risk (ALR) women
with no previous history of PTB, assessed at 20–22 gestational
weeks, g.w., n = 83; asymptomatic high risk
(AHR) women with a previous history of PTB, assessed at
both 20–22 g.w., n = 71, and 26–28 g.w., n = 58; and
women presenting with symptoms of preterm labor (PTL)
(SYM), assessed at 24–36 g.w., n = 65. Vaginal secretions
were dissolved in phosphate buffered saline and scanned
with a 9.4 T NMR spectrometer.
Results Six metabolites (lactate, alanine, acetate, glutamine/glutamate,
succinate and glucose) were analysed. In
all study cohorts vaginal pH correlated with lactate integral
(r = -0.62, p\0.0001). Lactate integrals were higher in
the term ALR compared to the AHR (20–22 g.w.) women
(p = 0.003). Acetate integrals were higher in the preterm
versus term women for the AHR (20–22 g.w.) (p = 0.048)
and SYM (p = 0.003) groups; and was predictive of
PTB\37 g.w. (AUC 0.78; 95 % CI 0.61–0.95), and
delivery within 2 weeks of the index assessment (AUC
0.84; 95 % CI 0.64–1) in the SYM women, whilst other
metabolites were not.
Conclusion High CVF acetate integral of women with
symptoms of PTL appears predictive of preterm delivery,
as well as delivery within 2 weeks of presentation
The vaginal microbiota associates with the regression of untreated cervical intraepithelial neoplasia 2 lesions
Emerging evidence suggests associations between the vaginal microbiota (VMB) composition, human papillomavirus (HPV) infection, and cervical intraepithelial neoplasia (CIN); however, causal inference remains uncertain. Here, we use bacterial DNA sequencing from serially collected vaginal samples from a cohort of 87 adolescent and young women aged 16–26 years with histologically confirmed, untreated CIN2 lesions to determine whether VMB composition affects rates of regression over 24 months. We show that women with a Lactobacillus-dominant microbiome at baseline are more likely to have regressive disease at 12 months. Lactobacillus spp. depletion and presence of specific anaerobic taxa including Megasphaera, Prevotella timonensis and Gardnerella vaginalis are associated with CIN2 persistence and slower regression. These findings suggest that VMB composition may be a future useful biomarker in predicting disease outcome and tailoring surveillance, whilst it may offer rational targets for the development of new prevention and treatment strategies
Intrauterine candidiasis in a twin pregnancy after myomectomy, in vitro fertilization and embryo transfer
A IVF twin pregnancy in a patient who had previously undergone a myomectomy ended in a intrauterine infection, placental abruption and fetal losses at 21 weeks. Intrauterine Candidiasis may have played a role in the pathogenesis of the unsuccesful outcome